Verify insurance eligibility, benefits, and network status, and create pre-service liability estimates.
Secure prior authorizations for outpatient imaging and office services, following up on delayed or denied requests.
Act as a liaison between payers and clinic schedulers, ensuring accurate documentation and issue resolution.
University of Utah Health enhances health and well-being through patient care, research, and education. With five hospitals and eleven clinics, it is nationally ranked and fosters a culture of collaboration, excellence, leadership, and respect.
Coordinate with providers, insurance companies, and hospital staff to secure pre-authorizations and address denials.
Review daily schedules, obtain authorizations via phone/fax/portals, and verify CPT/ICD-10 code alignment.
Communicate with patients about approvals, reschedules, or cancellations while maintaining HIPAA compliance.
Cardiac Study Center is a dedicated team at the forefront of cardiovascular medicine, empowering patients with the knowledge and treatment they need to lead heart-healthy lives. As a growing organization with deep roots in the Pacific Northwest, we foster continuous learning and collaboration among passionate professionals.
Provide medication prior authorization support for assigned clinics using the Epic In Basket system.
Manage prior authorizations from clinic to pharmacy, including submission, tracking, and follow-up.
Communicate with clinics, pharmacies, and insurance payers to ensure timely approvals and patient access.
UnityPoint Health is a healthcare system delivering medical services across the Midwest. Recognized as a Top 150 Place to Work in Healthcare, it fosters a culture of belonging and supports team members with development and well-being.
Submit and track prior authorization requests across multiple insurance payers
Gather and review clinical documentation required to support authorization requests
Follow up with payers on pending requests and monitor authorization status through resolution
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company operates with a fully remote workforce and emphasizes a detail-oriented, collaborative culture.
Process 60-80 insurance authorizations daily from insurance portals for patient referrals.
Verify authorization status and complete request forms for various insurance carriers.
Collaborate with the insurance team to maintain data integrity and communicate authorization status.
Our client is a leading ophthalmology clinic based in Texas with 17 locations and over 50 doctors. They are committed to employee fulfillment and career growth, guided by core values of integrity, respect, empathy, accountability, compassion, and honesty.
Ensure accurate verification of patient insurance benefits and authorizations.
Meet quantity and quality benchmarks for production and denial rates.
Utilize knowledge of medical terminology and insurance processes.
Gastro Health is one of the largest gastroenterology multi-specialty groups in the US with over 130 locations. They have a collaborative team and offer a great work/life balance.
Communicate with insurance companies and clinician offices to facilitate medication prior authorizations.
Assist patients with financial assistance resources and navigate pharmacy systems for claims processing.
Support medication adherence through direct patient communication and accurate documentation.
Shields Health Solutions is a healthcare solutions company specializing in specialty pharmacy services. The company fosters a collaborative culture focused on patient care and operational excellence.
Verify patient insurance eligibility, benefits, and coverage while communicating with insurance providers.
Obtain and track prior authorizations, and resolve coverage or authorization issues by phone.
Document insurance information in EHR systems and explain self-pay options to patients and families.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for healthcare facilities across the globe. They embrace a remote working environment and an international team collaborating from home.
Facilitate medication approvals by communicating with insurance companies and healthcare providers regarding prior authorizations.
Navigate pharmacy systems to enter data, adjudicate claims, process refills, and document patient interactions.
Assist patients with insurance claims, medication access challenges, and promote adherence through phone support.
Shields Health Solutions is a healthcare company dedicated to helping patients access life-changing medications through prior authorization and financial assistance support. They foster a collaborative, patient-focused culture with opportunities for professional growth in a fully remote setting.
Manage insurance authorizations for clients in PHP and IOP programs, including pre-certifications and concurrent reviews.
Verify benefits, obtain Single Case Agreements, and build medical necessity cases using ASAM, LOCUS, and CALOCUS criteria.
Maintain accurate authorization, denial, and SCA records and prepare appeals on denied authorizations.
AWA and PRC are dual behavioral health organizations operating PHP and IOP programs across South Florida. They exist to serve clients and families at their most critical moments.
Conduct medical necessity reviews for inpatient admissions and post-acute services using evidence-based guidelines.
Lead peer-to-peer discussions with attending physicians to clarify clinical documentation and support appropriate care decisions.
Collaborate with utilization management and care management teams to ensure consistent, cost-effective care.
Our partner company provides utilization management services for Medicare Advantage members, focusing on evidence-based clinical decision-making. It operates with a collaborative, matrixed team and emphasizes regulatory compliance and patient-centered care.
Eligibility Review: Review patient records and clinical documentation to determine eligibility for Form Health.
Record Collection: Manage requesting, faxing, and tracking medical records from external providers while ensuring HIPAA compliance.
File Communication: Maintain clear communication with patients and colleagues to keep them updated throughout the eligibility process.
Form Health is a virtual obesity medicine clinic that provides multi-disciplinary evidence-based obesity treatment through telemedicine. Founded in 2019, it is a venture-backed startup with an experienced clinical and leadership team, committed to a culture of inclusion and patient-first values.
Reviews insurance eligibility and coverage issues for patient appointments across practice sites.
Serves as the primary escalation contact for scheduling and practice teams on pre-visit and day-of-visit insurance questions.
Follows up post-visit to resolve PCP assignment and Coordination of Benefits discrepancies.
Bluebird Kids Health provides underserved communities with value-based pediatric primary care, aiming to help every child thrive through comprehensive services and around-the-clock support. The organization is a dynamic team focused on exceptional health outcomes and a rewarding environment for clinicians and staff.
Provide on-site and on-demand education on reimbursement challenges and support services for physician offices.
Educate on benefit investigation, prior authorization, Medicare and Commercial coverage, and patient communication streams.
Collaborate with internal hub support and case managers to ensure customer needs are met and track activities in CRM.
McKesson is a Fortune 10 healthcare company that delivers insights, products, and services to make quality care more accessible and affordable. It fosters a culture where employees can grow, make an impact, and thrive as they shape the future of health.
Manage end-to-end credentialing and recredentialing processes for healthcare providers.
Coordinate payer enrollment applications and ensure timely processing across commercial and government payers.
Maintain accurate credentialing files in compliance with regulatory standards and support cross-functional teams.
Knownwell is a weight-inclusive healthcare provider offering obesity care, primary care, nutrition counseling, and health coaching. Backed by $50M in funding from investors like CVS Health Ventures and a16z, they are scaling fast to expand access to evidence-based obesity care nationwide.
Review medical records to develop concise clinical reviews supporting authorization and reimbursement.
Facilitate communication with payors to ensure appropriate utilization management decisions.
Collaborate with interdisciplinary team to prevent denials and optimize patient care.
West Virginia University Health System is West Virginia’s largest health system, providing comprehensive healthcare services. With over 35,000 employees and 25 hospitals, it is the state's largest employer and offers a collaborative, patient-centered culture.
Provide direct support to customers navigating healthcare reimbursement, claims, and insurance processes.
Assist with verifying benefits, reviewing claims documentation, and maintaining compliant records.
Collaborate with internal teams to resolve complex reimbursement issues and improve workflows.
This partner company provides customer reimbursement coordination services for healthcare. They operate remotely and offer a collaborative environment with opportunities for professional development.
Support medical billing and revenue cycle activities including claims processing and AR follow-up.
Coordinate patient referrals, scheduling, and insurance verification with attention to detail.
Communicate with insurance companies and maintain accurate documentation across client systems.
SnappyCX provides outsourced administrative healthcare support to medical practices. They are a growing company focused on remote, independent contractor roles, emphasizing compliance with HIPAA and healthcare privacy requirements.
Act as a liaison between patients, providers, and insurance companies to ensure accurate data collection and compliance.
Verify insurance benefits, eligibility, and prior authorization requirements for scheduled patients.
Notify patients of estimated liability and act as a financial counselor regarding insurance and payment options.
Vail Health is the world's most advanced mountain healthcare system, providing exceptional care through a 56-bed hospital and various outpatient services. It is a nonprofit organization committed to patient-centered care and community well-being.
Verify patient insurance eligibility, benefits, authorization requirements, and referral needs prior to services.
Obtain referrals from primary care providers and ensure all referral requirements are met before scheduling.
Communicate insurance coverage, financial responsibility, and estimated costs to patients in a clear and empathetic manner.
Oshi Health is a virtual digestive health practice on a mission to transform GI care. As a startup, they offer a remote-first, mission-driven environment with a focus on improving patient lives.